ISSN: 2578-4676
Authors: Toth Z, Szalay B, Gyarmati B, Jalal DA, Vasarhelyi B* and Szabo T
Introduction: Prostate specific antigen (PSA) level is widely used as a screening tool for the identification of patients with increased risk of prostate malignancy. We tested whether PSA levels are affected by liver or renal impairment or systemic inflammation. Methods: We performed a retrospective analysis of almost 200 million records of the last 10 years of laboratory data. We selected those patients having both PSA and any of alanine aminotransferase (ALT), estimated glomerular filtration rate (eGFR) or C-reactive protein (CRP) results. We calculated the 5, 25, 50 (median), 75 and 95 per centile PSA values. Then the associations were adjusted for patients’ age. Results: We found significant association between ALT, eGFR and CRP levels and PSA. When age was included in the analysis the association between ALT or eGFR and PSA disappeared. The impact of PSA on CRP remained significant after its adjustment to patients’ age. Median and 75 per centile PSA values were more than 20% and 50% higher in patients with severe systemic inflammation (defined as CRP levels >50 mg/L) compared to those with low CRP (CRP levels <5 mg/L), respectively. Discussion: Reference and cut-off values of PSA should be adjusted just for patients’ age without considering their hepatic or renal condition. Elevated PSA levels should be interpreted cautiously in patients with severe inflammation. It is recommended to postpone PSA-based screening until the normalization of CRP.
Keywords: Prostate Malignancy; Retrospective Analysis; Renal Condition; Prostate Cancer; Renal Disease
